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Understanding the difference in Ojas-kshayaja/ Aavaranaja-Madhumeha & Prameha/Madhumeha based on Charaka-samhita

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Understanding the difference in Ojas-kshayaja/ Aavaranaja-Madhumeha & Prameha/Madhumeha based on Charaka-samhita
No.
Vibheda-Bindu (Differencial Point)
Aavaranaja Madhumeha
Prameha / Madhumeha
              i.             
Vyadhitva
Not eastablished, mentioned in Ch. Su. 17/78-82 as a cause of Prameha-pidakaa
Eastablished Vyadhi, mentioned among the  8 basic Sampraptis of Nidan-sthan Chapter-4. Detailed Management described in Ch. Chi. 6.
            ii.             
NidanPanchak
NidanPanchak is not mentioned systematically.
But Nidans are of 18 types of kshyas mebtioned.
NidanPanchak is mentioned systematically.

Bahudrava/ bahuslesma/ abadhamedaskarak nidanas.
          iii.             
Nidan
गुरु-स्निग्ध-अम्ल-लवणानि अतिमात्रं समश्नताम् !
नवम् अन्नं च पानं च निद्राम् आस्यसुखानि च !!
त्यक्तव्यायामचिन्तानां संशोधनम् अकुर्वताम् ! च.सू.-17/78-79
these are immediate causes only same as in prameha
आस्यासुखं स्वप्नसुखं दधीनि ग्राम्यौदकानूपरसा: पयांसि !

नवान्नपानं गुडवैकृतं च प्रमेहहेतु: कफ़कृच्च सर्वम् !!
च.चि.-6/4
          iv.             
Pramehatvam
Signs & Symptoms ‘Prameha’ is not Mentioned. Even the term ‘Prameha’ is not used. Direct manifestation of ‘Madhumeha’ is described.

Madhu and pra both have commom in meha.
The symptoms of ‘Prameha’ are
 Mentioned. Direct manifestation of ‘Madhumeha’ is not described.

Described in tathavidhasharireshu
And jatpramehimadhumehinova
Prabhoota-aavilaMootrata
Not mentioned directly.

No any sypmtoms mentioned
It is ‘Pratyatma-lakshana (Cardinal-feature) visible easily.
Dosha
Shleshma, Pitta as ‘Aavarak’ & Vat as Aavritta.
Vyanvayu&Apanvayu
शुक्रदोषप्रमेहास्तुव्यानापानप्रकोपजाः ||सु.नि.१/२०
Shleshma- Main Dosha responsible

Shleshma is at both places
Doshaja Types
Not mentioned
Well mentioned in details with individual Symtomatology.
Kaphaja-prameha- 10
Pittaja-prameha- 6
Vataja-prameha- 4
Dooshya
3 Only- 1.Medas 2.Mansa & 3.Ojas
1.Medas 2.Mansa 3. Kleda 4.Shukra, 5.Shonita 6.Vasa 7.Majja 8.Lasika 9.Ras 10. Ojas
            v.             
SROTAS
Mutravaha, swedavaha, medovaha
Mutravahastrotas, medovahastrotas
          vi.             
ROGAMARGA
Shakha&Marmasthisandhi
Marmasthisandhi
        vii.             
ADHISHTHAN
Basti, twacha
Basti(mutravahasansthana)
      viii.             
AGNI
Dhatvagnimandhya
Dhatvagnimandhya
          ix.             
SAM/NIRAM
Sam
Sam
            x.             
AASHAY
Aam-Pakvashaya
Pakvashaya
          xi.             
SROTO-DUSHTI
Sanga
Sanga, Atipravriti
        xii.             
VYADHI-PRAKAR
Aashukari
Chirakari
      xiii.             
SADHYASADHYATA
Kritchhasadhya
Yapya/Asadhya
      xiv.             
SAMPRAPTI
श्लेष्मा पित्तं च मेदश्च मांसं चातिप्रवर्धते||तैरावृतगतिर्वायुरोजआदाय गच्छति| यदा बस्तिं तदा कृच्छ्रो मधुमेहः प्रवर्तते||स मारुतस्य पित्तस्य कफस्य च मुहुर्मुहुः| दर्शयत्याकृतिं गत्वा क्षयमाप्यायते पुनः|| च. सु.१७/७९, ८०,८१
ओजःपुनर्मधुरस्वभावं, तद्यदारौक्ष्याद्वायुःकषायत्वेनाभिसंसृज्यमूत्राशयेऽभिवहतितदामधुमेहंकरोति ||
च.नि.४/३७
        xv.             
POORVA-ROOPA
Not mentioned
Direct glycosuria
त्रयस्तु खलु दोषाः प्रकुपिताः प्रमेहानभिनिर्वर्तयिष्यन्त इमानि पूर्वरूपाणि दर्शयन्ति; तद्यथा- जटिलीभावं केशेषु, माधुर्यमास्यस्य, करपादयोः सुप्ततादाहौ, मुखतालुकण्ठशोषं, पिपासाम्, आलस्यं,मलं काये, कायच्छिद्रेषूपदेहं, परिदाहं सुप्ततां चाङ्गेषु, षट्पदपिपीलिकाभिश्च शरीरमूत्राभिसरणं, मूत्रे च मूत्रदोषान्, विस्रं शरीरगन्धं, निद्रां, तन्द्रां च सर्वकालमितिच.नि.४/४७
स्वेदोऽङ्गगन्धः शिथिलाङ्गता च शय्यासनस्वप्नसुखे रतिश्च|
हृन्नेत्रजिह्वाश्रवणोपदेहो घनाङ्गता केशनखातिवृद्धिः||च.चि.६/१३
शीतप्रियत्वं गलतालुशोषो माधुर्यमास्ये करपाददाहः| भविष्यतो मेहगदस्य रूपं मूत्रेऽभिधावन्ति पिपीलिकाश्च||च.चि.६/१४
      xvi.             
UPADRAVA
उपेक्षयाऽस्य जायन्ते पिडकाः सप्त दारुणाः| च. सु.१७/८२
उपद्रवास्तु खलु प्रमेहिणां तृष्णातीसारज्वरदाहदौर्बल्यारोचकाविपाकाः पूतिमांसपिडकालजीविद्रध्यादयश्च तत्प्रसङ्गाद्भवन्ति च. नि.4/४८
    xvii.             
VYADHI- DHATUGATATVA
May be seen if not treated properly
Seen
  xviii.             
DOSH PRAKOP PATTERN
     विकृतिविषमसमवेत
प्रकृतिसमसमवेतपरक
      xix.             
Swatantra/ Paratantra Kartritva
           स्वतन्त्रकर्तृत्व Due to Direct Ojasa-kshaya.
परतन्त्रकर्तृत्व Ojasa-kshaya is later event.
        xx.             
LAKSHAN-UTPATTI
Not mentioned because there is no fix clinical presentation because of avaranaFenomena.

कषायमधुरंपाण्डुरूक्षंमेहतियोनरः|
वातकोपादसाध्यंतंप्रतीयान्मधुमेहिनम्||च.नि.४/४४
      xxi.             
CHIKITSA SIDDHANTA
As per Avaranchikitsa& symptomatic shoshan dominance.
रसायनानां सर्वेषामुपयोगः प्रशस्यते||२४१||
शैलस्य जतुनोऽत्यर्थं पयसा गुग्गुलोस्तथा|२८/२४२
पित्तावृते तु पित्तघ्नैर्मारुतस्याविरोधिभिः|
कफावृते कफघ्नैस्तु मारुतस्यानुलोमनैः||च. चि.२८/२४५
स्थूलःप्रमेहीबलवानिहैकःकृशस्तथैकःपरिदुर्बलश्च|
सम्बृंहणंतत्रकृशस्यकार्यंसंशोधनंदोषबलाधिकस्य
च. चि.१५
    xxii.             
PATHYAPATHY
Pathya:-
आहार:-येविष्किरायेप्रतुदाविहङ्गास्तेषांरसैर्जाङ्गलजैर्मनोज्ञैः |
यवौदनंरूक्षमथापिवाट्यमद्यात्ससक्तूनपिचाप्यपूपान् ||१९||
मुद्गादियूषैरथतिक्तशाकैःपुराणशाल्योदनमाददीत |
दन्तीङ्गुदीतैलयुतंप्रमेहीतथाऽतसीसर्षपतैलयुक्तम् ||२०||
सषष्टिकंस्यात्तृणधान्यमन्नंयवप्रधानस्तुभवेत्प्रमेही | च. चि.६/२१
विहार:-व्यायामयोगैर्विविधैः प्रगाढैरुद्वर्तनैः स्नानजलावसेकैः|
सेव्यत्वगेलागुरुचन्दनाद्यैर्विलेपनैश्चाशु न सन्ति मेहाः||च. चि.६/५०

Apathya:-
आहार:- दधीनि ग्राम्यौदकानूपरसाः पयांसि|
नवान्नपानं गुडवैकृतं च प्रमेहहेतुः कफकृच्च सर्वम्||च. चि.६/४
हायनकयवकचीनकोद्दालकनैषधेत्कटमुकुन्दकमहाव्रीहिप्रमोदकसुगन्धकानांनवानामतिवेलमतिप्रमाणेनचोपयोगः, तथासर्पिष्मतांनवहरेणुमाषसूप्यानां, ग्राम्यानूपौदकानांचमांसानां, शाकतिलपललपिष्टान्नपायसकृशराविलेपीक्षुविकाराणां, क्षीरनवमद्यमन्दकदधिद्रवमधुरतरुणप्रायाणांचोपयोगः,च. नि.४/५
विहार:-आस्यासुखंस्वप्नसुखंच. चि.६/४
मृजाव्यायामवर्जनं, स्वप्नशयनासनप्रसङ्गः| च. नि.४/५
Same pathyapathya
  xxiii.             
Conclusions
1. Basically it is in ‘Kiyantahshirshiya’ chapter which deals with marmopghat due to dhatukshaya condition.

2. Ayurveda has no concept of organic pathology but on the sound basis of 7 dhatus and ojus, it is   there.

3. Ojus is the supreme dhatu.

4. Dhatus are in srotas until not  metabolized as desired state of dhatu ( Parinamapadyaman). 

5. Avayava or organ is only shaped by  sthir-dhatu layer by layer dhatu evolve as avayava
nothing else.

6. Even after organic repair or even transplant there is a strong need of correction in dhatuparinaman.

7. Poor dhatu constitute the poor organ and strong to strong.

8. That’s why this chapter is written for how dhatukshaya leads the marmopghtat.

9 Madhumeha is given as an example of ojuskshaya not as an example of pure aavarna.

10. This chapter is mainly written for 18 kshyas (3 dosha+ 7 dhatu 2 mala + 5  indriya mala + 1 ojus) and in result avayavanash.
11. Pl don’t consider prameha and madhumeha commonly only one type of partantra prameha is madhumeha
Othervise madhumeha is poly factorial poly symptoms and tt.
       1.      This is the details about 20 prameha
       2.      Madhumeha can be the swatantra as in ch. Su. 17
       3.      and partantra as in prameha
       4.      jatapramehi and mahumehi are two different         diseases.
       5.      Sthool-
       6.      Balwan-
       7.      Krisha-
       8.      Durbal pramehi are further more variants.
       9.      Sapoorvarupa or apoorvarupa are further more variants
        10.  Prakati-bhuyastwad means genrally they have long history of excessive and repeatative nidan
but mahumeha can be immediately after with any reason of ojokshaya.
  xxiv.             
Practical aspect     
The patients who don’t have family history  but they have sequence of Nidanas excessively like….

 intake of Fast
       junk
        non-veg. food
       wine or bear
           anabolic steroids
           irregular life style
       Adulterated food
          Irregular exercise
       Excessive proteins etc are more close to Avarana-janit-madhumeha due to dhatvagni-mandya & Ojas-kshaya conditions. Gestation, Stress induced, Higher Steroids/antibiotics etc. induced, Hormonal therapy & Surgical stress induced Diabetes may be taken into consideration of Ojas-kshayaja/avaranaja Madhumeha.
The patients who don’t have avaran/ojas kshaya nidanas but their presentation is as per santarpaneeya concept are more close to classical Prameha/Madhumeha. This must be further understood as mentioned above before planning of Samprapti-vighatan.




Presented by

 Dr. Keval Monapara
B.A.M.S., M.D. 1st Year
P.G. Dept. of K.C.
Govt. Akhandanand Ayurved College
Bhadra, Ahmedabad-1, Gujarat, India.

 Guided by

 Dr. Surendra A. Soni
M.D., PhD
Professor & Head
P.G. Dept. of  K.C.
Govt. Akhandanand Ayurved College
Bhadra, Ahmedabad-1, Gujarat, India.
Checked, Correctified & Verified by

1.Prof. Shri Krishna Khandel
M.D., PhD.
Ex-H.O.D.
Dept. of Roga & Vikriti Vigyan
National Institute of Ayurveda,
Amer Road, Jaipur, Raj. India
Arogya Laxmi Ayurvedic Health Care
D- 44, Roopvihar Colony, Block- D, 
Siddhartha Nagar, Jagatpura, Jaipur-302017
 Rajasthan., India.
www.arogyalaxmi.com
Phone: +91 141 4024645 
Mob. No. +91 9772828871   
2. Vaidyaraja Subhash Sharma
M. D. Kayachikitsa (Jamnagar)
New Delhi, India.
email- vaidyaraja@yahoo.co.in
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[11/1, 00:57] Tapan Vaidya:  Today morning I experienced a wonderful result in a gasping ILD pt. I, for the first time in my life used Hemgarbhpottali rasa. His pulse was 120 and O2 saturation 55! After Hemgarbhapottali administration within 10 minutes pulse came dwn to 108 and O2 saturation 89 !! I repeated the Matra in the noon with addition of Trailokyachintamani Rasa as advised by Panditji. Again O2 saturation went to 39 in evening. Third dose was given. This time O2  saturation did not responded. Just before few minutes after a futile CPR I hd to declare him dead. But the result with HGP was astonishing i must admit. [11/1, 06:13] Mayur Surana Dr.:  [11/1, 06:19] M gopikrishnan Dr.: [11/1, 06:22] Vd.Vivek savant:         Last 10 days i got very good result of hemgarbh matra in Aatyayik chikitsa. Regular pt due to Apathya sevan of 250 gm dadhi (freez) get attack asthmatic then get admitted after few days she adm
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DIFFERENCES IN PATHOGENESIS OF PRAMEHA, ATISTHOOLA AND URUSTAMBHA MAINLY AS PER INVOLVEMENT OF MEDODHATU

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Compiled  by Dr.Surendra A. Soni M.D.,PhD (KC) Associate Professor Dept. of Kaya-chikitsa Govt. Ayurveda College Vadodara Gujarat, India. Email: surendraasoni@gmail.com Mobile No. +91 9408441150
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UNDERSTANDING THE DIFFERENTIATION OF RAKTAPITTA, AMLAPITTA & SHEETAPITTA

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UNDERSTANDING OF RAKTAPITTA, AMLAPITTA  & SHEETAPITTA  AS PER  VARIOUS  CLASSICAL  ASPECTS MENTIONED  IN  AYURVEDA. Compiled  by Dr. Surendra A. Soni M.D.,PhD (KC) Associate Professor Head of the Department Dept. of Kaya-chikitsa Govt. Ayurveda College Vadodara Gujarat, India. Email: surendraasoni@gmail.com Mobile No. +91 9408441150
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Case-presentation- Self-medication induced 'Urdhwaga-raktapitta'.

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This is a c/o SELF MEDICATION INDUCED 'Urdhwaga Raktapitta'.  Patient had hyperlipidemia and he started to take the Ayurvedic herbs Ginger (Aardrak), Garlic (Rason) & Turmeric (Haridra) without expertise Ayurveda consultation. Patient got rid of hyperlipidemia but hemoptysis (Rakta-shtheevan) started that didn't respond to any modern drug. No abnormality has been detected in various laboratorical-investigations. Video recording on First visit in Govt. Ayu. Hospital, Pani-gate, Vadodara.   He was given treatment on line of  'Urdhwaga-rakta-pitta'.  On 5th day of treatment he was almost symptom free but consumed certain fast food and symptoms reoccurred but again in next five days he gets cured from hemoptysis (Rakta-shtheevan). Treatment given as per availability in OPD Dispensary at Govt. Ayurveda College hospital... 1.Sitopaladi Choorna-   6 gms SwarnmakshikBhasma-  125mg MuktashuktiBhasma-500mg   Giloy-sattva-                500 mg.  
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Case-presentation: 'रेवती ग्रहबाधा चिकित्सा' (Ayu. Paediatric Management with ancient rarely used 'Grah-badha' Diagnostic Methodology) by Vd. Rajanikant Patel

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[2/25, 6:47 PM] Vd Rajnikant Patel, Surat:  रेवती ग्रह पीड़ित बालक की आयुर्वेदिक चिकित्सा:- यह बच्चा 1 साल की आयु वाला और 3 किलोग्राम वजन वाला आयुर्वेदिक सारवार लेने हेतु आया जब आया तब उसका हीमोग्लोबिन सिर्फ 3 था और परिवार गरीब होने के कारण कोई चिकित्सा कराने में असमर्थ था तो किसीने कहा कि आयुर्वेद सारवार चालू करो और हमारे पास आया । मेने रेवती ग्रह का निदान किया और ग्रह चिकित्सा शुरू की।(सुश्रुत संहिता) चिकित्सा :- अग्निमंथ, वरुण, परिभद्र, हरिद्रा, करंज इनका सम भाग चूर्ण(कश्यप संहिता) लेके रोज क्वाथ बनाके पूरे शरीर पर 30 मिनिट तक सुबह शाम सिंचन ओर सिंचन करने के पश्चात Ulundhu tailam (यह SDM सिद्धा कंपनी का तेल है जिसमे प्रमुख द्रव्य उडद का तेल है)से सर्व शरीर अभ्यंग कराया ओर अभ्यंग के पश्चात वचा,निम्ब पत्र, सरसो,बिल्ली की विष्टा ओर घोड़े के विष्टा(भैषज्य रत्नावली) से सर्व शरीर मे धूप 10-15मिनिट सुबज शाम। माता को स्तन्य शुद्धि करने की लिए त्रिफला, त्रिकटु, पिप्पली, पाठा, यस्टिमधु, वचा, जम्बू फल, देवदारु ओर सरसो इनका समभाग चूर्ण मधु के साथ सुबह शाम (कश्यप संहिता) 15 दिन की चिकित्सा के वाद
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